Healthy Skepticism Library item: 4439

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Publication type: news

Harvie J. Rebels with a cause. Australian Doctor Weekly 2006 Mar 30

Full text:

Whether it ’ s saving trees or fighting to keep the abortion pill out of Australia, GPs seem more drawn than most to taking up a cause. By Jeni Harvie

THEY’RE protesting against animal research, lobbying on euthanasia, fighting for native forests and up in arms over war. In the service of their favourite cause, doctors around Australia are picketing, writing letters, debating, being interviewed and speaking to anyone who will listen.

And the bulk of those doctors who assume the activist mantle are GPs. “The majority of our membership [of about 250] are GPs,” says retired vascular surgeon Dr Bill Castleden, chairman of Doctors for the Environment Australia.

“I suspect this is because GPs spend a lot of time trying to advise patients how to be more healthy – they see the link between a healthier environment and healthier people.

“Specialists are more focused on fixing someone with an existing problem. They are not so much into prevention.”

AMA president Dr Mukesh Haikerwal agrees GPs see the health impacts of social policy, making them more likely to feel the need to speak out.

“GPs are aware of not just the physical but the emotional and psychological impacts [of social policy] on their patients, and see it as part of their responsibility to raise awareness about injustices,” he says.

FIGHTINGFOR A SAFERWORLD

TWENTY-five years ago Canberra GP Dr Sue Wareham came to the conclusion nuclear weapons “made a mockery of what we do as doctors” and that she had a moral obligation to take action.

“We try to prevent suffering. Nuclear weapons kill, maim, burn and mutilate,” she says in a measured tone. “The whole concept was absolutely abhorrent to me. I felt morally I had to do something about it.”

Dr Wareham is immediate past-president of the Medical Association for Prevention of War (MAPW) and was awarded a Medal of the Order of Australia in January for her “service to the community and to the peace movement, particularly through MAPW”.

She believes doctors have a particular responsibility to speak out. “Doctors are still listened to,” she says. “When doctors say nuclear weapons should be abolished, the message carries some weight. And nuclear weapons are still a pressing problem today. There are about 30,000 weapons in the world, with the chance of them being used even higher now than in the past.”

Most of the association’s 500-600 member doctors are GPs. Sydney GP Dr Gillian Deakin first went to one of the organisation’s meetings because she was “horrified that Australian troops would be obliged to participate in an illegal war” in Iraq.

“If we don’t speak out, we are tacitly approving of [the government’s action],” explains Dr Deakin, who is now the association’s vice-president and NSW co-ordinator. “I’m an unreconstructed idealist and have always been interested in peace. War is a total anathema to what doctors are trying to do.”

Dr Deakin, who has also demonstrated with Greenpeace, describes protesting outside Kirribilli House, the Sydney home of Prime Minister Mr John Howard, as her “Sunday-morning speciality”.

“When the doctors turn up with white coats and stethoscopes, we lend considerable gravitas and credibility to some of the peace groups. And I always wear my pearls because I feel anyone who speaks with pearls on has a lot more credibility,” she says with a laugh.

Dr Deakin doesn’t hesitate to take her activism into the surgery, scattering MAPW material among the Woman’s Days. “I don’t seek to ram [my beliefs] down patients’ necks but I think it is important to be informed. My patients can always vote with their feet, and I would respect that.”

The MAPW web site is at www.mapw.org.au

SMALLFOOTPRINTS, BIGHEART

EARLIER this month Brisbane GP Dr David King climbed on his unicycle and rode 10km for Oxfam’s Walk Against Want, raising $3000 in the process.

“I like a challenge, it’s good exercise and it’s good for the environment,” Dr King says. “I’ve always been a bit of a greenie. I cycle to work each day, my house runs on solar power and for many years I’ve supported organisations doing good work.”

Two years ago Dr King decided to “put his money where his mouth is” and joined the management committee of Doctors for the Environment Australia.

“As an individual I’m attempting to live happily without imposing an enormous ecological footprint on the planet. As an activist, I’m attempting to educate and enlist other people to a more caring and sustainable way of living.”

Dr King, who is also a lecturer at the University of Queensland’s school of medicine, says GPs are uniquely placed to become involved in causes.

“GPs tend to be more idealistic, they have more time [than specialists] and are not so career-focused,” he says. “Their expertise is in prevention and managing risk factors. They know that if they reduce the risk now the patient will survive longer. It’s a model that gives GPs a long-term view.”

Over the years Dr King’s political commitment has seen him march in the streets against war, co-ordinate a bush regeneration project, take part in the Terania Creek forestry blockade in northern NSW and plant trees in a peace park. Yet he doesn’t see himself as an activist.

“Most of my colleagues and patients would be unaware of my extracurricular activities,” he says. “I just have a strong sense of justice and fairness, and a belief that the forces of greed, ignorance and hatred will increase without efforts to counter them.”

The Doctors for the Environment Australia web site is at www.dea.org.au

COMMITTEDFORLIFE

FOR Sydney GP Dr Catherine Lennon, it was her long involvement with women’s health and fertility problems, in particular through providing pregnancy and post-abortion counselling, that induced her to take on the role of medical spokesperson for Australians Against RU486.

“I’ve had a lot more experience than your average doctor about understanding the dilemmas women face with unplanned pregnancy and then seeing very good outcomes in women who are initially upset about being pregnant but, with support and counselling, change to being very positive,” she says.

A committed anti-abortion campaigner, Dr Lennon is also the medical spokeswoman for Doctors for Life and was previously involved with Right to Life.

“I talk to women who have had a traumatic experience from abortion, women who come to me about specialist fertility problems, women who desperately want to have a baby and who have rushed into having an abortion and now that is a decision they regret,” she says quietly but with conviction.

“I’m very passionate about this. I’ve had difficult pregnancies myself. Being a woman and having difficult pregnancies, I’m very empathetic to my patients.” Dr Lennon is now a mother but doesn’t want to talk about her family life, insisting it is not related to her political activity.

She does not believe her views create a conflict of interest when treating patients. “My role is to provide supportive counselling, information about all their options. I never say to women, ‘Don’t have an abortion’. I do what’s called non-directive counselling.

“I certainly won’t be prescribing RU486 because I think it has very serious health risks for women … and I don’t refer women for abortions.”

Dr Lennon believes GPs have an important role to play in patient and community education. “I think a lot of GPs are very holistic. They look at the psychosocial aspects of patients’ conditions and on the whole are better at patient education than some specialists.”

The Australians Against RU486 web site is at www.aaru486.com.au

THECONSTANTCAMPAIGNER

DR Peter Mansfield was doing his student elective in Bangladesh back in 1981 when he saw advertising by an international drug company recommending anabolic steroids be used to treat malnourished children.

“I was appalled,” recalls the GP from Willunga, SA. “At the time, I was trying to work out where I wanted to go with my medical career and decided I might be able to do something about [misleading drug promotion].”

Dr Mansfield adopted a strategy used by Amnesty International. He started writing letters outlining his concerns about various drugs and sent copies to doctors around the world who signed them and sent them on to the relevant drug company.

The organisation Dr Mansfield founded back in 1983 — the Medical Lobby for Appropriate Marketing, or MaLAM — has now evolved into Healthy Skepticism, an information network with 100 paid-up members and more than 1000 free subscribers around the world. About 70% of subscribers are doctors and about 70% of those are GPs, Dr Mansfield says.

One of the biggest wins from his more than 20 years of campaigning was the withdrawal of a chloramphenicol/streptomycin combination being sold over the counter for diarrhoea in the Philippines after concerns were raised it might lead to an increase in drug-resistant tuberculosis.

Although he takes a big-picture view, Dr Mansfield says his continuing practice as a GP is essential. “I don’t get to be in an ivory tower and I can keep in touch with the realities of being a clinician.”

Healthy Skepticism has a “complicated” relationship with drug companies, he says. “There are many good people in the industry … but there are others who dislike us intensely.”

Nonetheless, he scoffs at the film The Constant Gardener, which gives the impression drug companies will murder people who question their products. “I’ve been working in this field for nearly 25 years and I’ve not been murdered once,” he says.

The Healthy Skepticism web site is at www.healthyskepticism.org

HELPINGHEALCOMMUNITIES

WHEN race-based rioting erupted in Sydney last December, Dr Jamal Rifi closed his surgery for three days so he could work with young people in his local area and help restore order.

The Western Sydney GP is a founding member of Australian Muslim Doctors Against Violence, a group formed after last year’s London Tube and bus bombings to work with the Australian Muslim community and counteract some of the negative publicity directed towards it. The group now has 84 members nationally, two-thirds of them GPs.

“We believed as professional people we would be able to project a professional image to the wider community and be a commonsense voice in the midst of all the mayhem,” says Dr Rifi, who arrived in Australia from the Lebanon in 1984.

“There was so much misinformation and demonising going on,” he says. “Our voices were really a drop in the bucket in a sea of hatred, but it was important to speak collectively and engage with the whole community.”

Although the energetic Dr Rifi has been a member of everything from the NSW Medical Board and the state’s expert advisory group on drugs and alcohol to the University of Sydney’s Australian-Lebanese Foundation, a major focus is his local community, particularly through his role as president of the Lakemba Sport and Recreational Club.

“It was just a small soccer club and it was going downhill fast,” he says. “Now we have introduced cricket and karate, our membership has grown to 250, and it involves people from all backgrounds and religions,” he says.

“Sport is a good way for young people to become engaged and motivated. It’s a way to instil pride [and] teach values.”

Dubium sapientiae initium. (Doubt is the origin of wisdom.)
- Descartes, Meditations on First Philosophy 1641

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